Question Wedge Osteotomy for Interphalangeal Joint of Toe - CPT Code?

cclarson

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The patient had a transverse plane deformity of the 2nd toe, which the doctor corrected using a medial wedge osteotomy at the proximal interphalangeal joint. I think this scenario could be described with 28124, but I would love a second opinion. Thank you!
 

cclarson

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Good thing you asked. Code 28124 is not for a wedge osteotomy. Look at 28312.
I'm still pretty new to coding podiatry, thank you for your input. Could you look over the op note for me, just incase the body of the report describes something different?

POSTOPERATIVE DIAGNOSIS:
Transverse plane deformity of the second toe of the left foot with lateral deviation of the second toe.

OPERATION PERFORMED:
Repair of transverse plane deformity of second toe with medial based wedge created at the proximal interphalangeal joint of the second toe with K-wire fixation.

DESCRIPTION OF PROCEDURE:
The patient was brought into the OR and placed supine on the table. Initially IV sedation was initiated. This was converted to general prior to the skin incision. The left lower extremity was prepped with DuraPrep to the knee and draped in the usual sterile fashion. The ankle tourniquet was inflated to 250.

Attention was directed to the second toe where a 3 cm incision was created overlying the dorsal aspect of the toe. The incision was deepened down to the extensor tendon. The extensor tendon was released at the PIPJ and reflected proximally. The toe was noted to be deformed in two planes. The sagittal plane with a downward contracture of the toe and in the transverse plane with a lateral deviation of the toe. The decision was made to perform a wedge osteotomy at the proximal interphalangeal joint with the base of the edge medial and dorsal. The wedge was removed. The toe was placed in the corrected position and fixated with a 0.062 smooth K-wire. Intraoperative x-rays validated satisfactory postoperative position of the toe and satisfactory postoperative position of the toe and satisfactory placement of the internal fixation.

The wound was flushed with copious amounts of sterile saline. The extensor tendon was repaired with 3-0 Vicryl and the skin was repaired with 4-0 nylon. The above noted amounts of local anesthetic were then injected about the surgical sites. The foot was bandaged with Xeroform gauze, dry sterile dressing, Kling, and Coban. After release of the tourniquet, there was noted to be normal blood flow to all digits of the left foot. The patient left the OR in stable and satisfactory condition.
 

Orthocoderpgu

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No, your surgeon did a wedge osteotomy but his/her documentation is a bit lacking. It's only documented that one was performed. No detail on the instrumentation used, location of cuts, any issues or complications.
 
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